1.1 General Information From January 2003 to June 2004, 45 cases of vestibular cysts were diagnosed in outpatient clinics of our department, of which 25 cases were combined with infections, all of them were unilateral; age was 22 to 53 years old, the average age was 32 years old; duration of the disease was 2 weeks to 3 years, and there were 3 cases of recurrent episodes; the diameter of the cysts was 2.0 to 7.0cm. Group and control group, 25 cases in the observation group and 20 cases in the control group. The difference between the two groups in general condition, age, occupation, physical condition, and disease was not significant (P>0.05) and was comparable.
1.2 Methods
1.2.1 Instruments and equipment HBS-A multifunctional microwave surgical therapeutic instrument produced by Nanjing Huabei Electronic Medical Equipment Co. Ltd. was used with an operating frequency of (2450±30) MHz, and an output power of: 20-30W in the observation group and 50W in the control group.
1.2.2 Surgical methods In the observation group, (1) the patients took the cystotomy position, after routine disinfection, local infiltration anesthesia with 0.5% lidocaine. (2) Make a longitudinal incision with a microwave cutter at the junction of skin and mucous membrane near the mucous membrane side of the inner labia minora of the cyst with a power of 20-30W, the length of the incision is nearly the whole length of the cyst (especially the lower end of the incision needs to be located at the very bottom of the cyst in order to facilitate the discharge of the internal fluid), and cauterize layer by layer up to the wall of the cyst to exclude cystic fluid or pus, and when the fluid is completely excluded, flush the cystic cavity with 100 ml of 0.2% metronidazole injection plus 80,000 U of gentamicin injection. The cystic cavity. (3) Change the needle-like probe into the cystic cavity multi-point cauterization, the operation is completed. (4) Postoperative 1, 3, 5 days respectively with the probe test, 3 to 4 times. (5) For combined infection, oral metronidazole 0.4g, 3 times a day, and penicillin 800,000U intramuscular injection, 2 times a day, ****5-7 days. Control group:Except for the output power of 50W, the rest of the operation is the same as the observation group.
1.3 Statistical methods t-test was used.
2 Results
2.1 Surgical time and intraoperative bleeding See Table 1.
Table 1 Comparison of surgical time and intraoperative bleeding between the two groups (omitted)
The difference between the average surgical time of the observation group and the control group was significant (P<0.05), and the difference in intraoperative bleeding was not significant.
2.2 Postoperative pain and recovery See Table 2.
Table 2 Comparison of postoperative adverse reactions and recovery time between the two groups (omitted)
The difference in recovery time between the two groups was significant (P<0.05). Another 2-month follow-up, all cured, the cure rate is 100%, and all have no local scar formation, no recurrence, further proving the superiority of microwave therapy.
3 Discussion
3.1 Traditional treatment Vestibular cyst is a common gynecological disease that occurs due to the obstruction of the vestibular gland ducts caused by inflammation and epithelial hyperplasia, etc. The traditional treatments include cyst removal, cystostomy (with incision and drainage for combined infections), and aspiration of intracapsular fluid. The traditional treatment methods are easy to bleed during the operation, suture and suture removal, incision and drainage must be changed daily, and suction method is easy to recur. With the popularization of microwave therapy, the above disadvantages can be avoided.
3.2 Microwave therapy Microwave is a high-frequency electromagnetic waves, it has a significant thermal effect, no dielectric effect, no neuromuscular excitability, the electrode can leave the skin, the tissue resistance to the current is small, and its biophysical role in the heat pole shock. There are no obvious side effects on human tissues during the operation. Microwave effect on the human body produces thermal and non-thermal effects, due to the role of electromagnetic waves, so that the body of dielectric dipoles with frequency changes and rotation, that is, the organization of water molecules in the positive and negative position changes, microwave electric field polarity according to the frequency of 2450MHz × l0 6 / s high-speed changes in vibration and rotation of the process of friction with each other to produce the above effect, so that the tissue internal warming and expansion to achieve the cauterization, coagulation and hemostasis. The effect. It is different from laser, high-frequency electricity: microwave is internal heating (induction heating method), with internal and external heat, without heat transfer process, instantaneous high temperature, and is not easy to diffuse and other characteristics. It can not only make the tissue protein denaturation, coagulation, but also closed 3 ~ 4mm diameter blood vessels, so as to achieve the effect of hemostasis. Microwave thermal effect and power size, radiation time is proportional.
In summary, microwave treatment of vestibular gland cysts has many advantages. It has almost no local bleeding (the main bleeding point is located in the anesthesia needle hole), the anatomical level is clear, the operation field is clear, and the patient is free to move around after the operation. After treatment, the residual intracapsular fluid is discharged regularly with a probe to accelerate healing, prevent local scar formation and contracture, avoid postoperative stoma stenosis, and prevent recurrence. However, if its power is too large, it can make the tissue charring sharply, and the tissue becomes hard, and the microwave knife is small, and it is difficult to cut this kind of tissue; the other power increases, the local tissue destruction range is also large, which affects the postoperative recovery. Therefore, the author summarizes the experience, the second half of the treatment to 20 ~ 30W power-based, achieved good results.